Antiepileptic drugs for acute convulsive seizures or status epilepticus in adults and children

Question 2: In adults and children with acute convulsive seizures or status epilepticus, when IV access is available, which IV antiepileptic drugs when compared to placebo/comparator produce benefits/harm in the specified outcomes?

Management of epilepsy

Population: adults and children presenting with status epilepticus or acute convulsive seizures

Interventions:

IV diazepam

IV phenobarbital

IV lorazepam

IV phenytoin

Comparison: one intervention versus other

Outcomes:

non-cessation of seizures

death

adverse effects including requirement for ventilatory support

neurocognitive impairment (long-term).

Recommendation(s)

In convulsive status epilepticus, IV benzodiazepine (lorazepam or diazepam) should be administered. If available, IV lorazepam is preferred over IV diazepam.
Strength of recommendation: STRONG

For sustained control or if seizures continue after benzodiazepines administration, IV phenobarbital or phenytoin should be administered.
Strength of recommendation: STRONG